• Gina Luciano, Lydia Hambour, Paul Luciano, Eric Holmboe, Sudeep Aulakh, Simon Fleming, and Michael Rosenblum.
• Baystate Health, Springfield, MA, USA. Gina.Luciano@baystatehealth.org.
• J Gen Intern Med. 2020 Nov 1; 35 (11): 3333-3337.

AbstractSince 2011, aviation has revolutionized their approach to safety. The aviation industry has adopted a multi-faceted approach to improve safety through decreasing duty hour limits and implementing processes to mitigate fatigue-related errors as well as creating cultural shifts in responsibility for safety. These changes have been guided by data generated by quality-improvement methodology. In contrast, duty hour limits in graduate medical education have not yet seen dramatic data-driven reform. Key advancements in aviation fatigue mitigation and implications for residency education are explored in this article. Scientifically based processes to optimize duty hours, quality-improvement strategies to iteratively monitor and reform duty limits, systematic change focusing on a just culture, and financial disincentives and incentives as a catalyst for change are discussed.

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